Barack Obama has certainly not been perfect (even if his faults have been greatly exaggerated) and the prospect of Hillary Clinton as president leaves me quite unexcited about voting. Despite this, it is important to remember the alternative. One of the most significant differences between potential Democratic presidents and Republican presidents is the type of people they will appoint to the Supreme Court. Nothing is definite as Republican appointees have sometimes voted for liberal positions (most recently John Roberts supporting the Affordable Care Act), but with the increased ideological gap it is best to fear the worst. While I would separate this from any pressure for Ruth Bader Ginsberg to retire before she is ready, Think Progress does have some warnings as to what will occur if she is replaced by a Republican president:

No More Marriage Equality: United States v. Windsor — the decision striking down the unconstitutional Defense of Marriage Act — was a 5-4 decision with Ginsburg in the majority. If Ginsburg is replaced by another conservative, DOMA could roar back to life. At the very least, the nation’s drive towards nationwide marriage equality could come to a screeching halt.

Criminalizing Sex: Although Lawrence v. Texas, which struck down Texas’ “sodomy” law, was a 6-3 decision, one of those six justices has since been replaced by the staunchly conservative Justice Samuel Alito. If another member of the Lawrence majority is replaced, it could lead to gay sex being outlawed entirely in several states. Lawrence‘s holding, however extends far beyond gay couples to prohibit laws criminalizing non-commercial sexual activity between consenting adults. Thus, if Lawrence falls, the government could find its way into every American’s bedroom.

Watering Down Minority Votes: Five justices voted in League of United Latin American Citizens v. Perry to strike part of a Texas redistricting map because it tried to protect an incumbent Republican congressman by reducing the impact of Latino voters. If Ginsburg is replaced by a conservative, these kinds of tactics could become common.

Judges for Sale: Four justices joined a dissent arguing that there’s nothing wrong with a wealthy businessman spending $3 million to place a judge on a state supreme court — only to have that judge cast the key vote to overturn a $50 million verdict against the businessman’s company. Ginsburg’s replacement could places judges up for sale.

Millions Without Health Care: Finally, the decision that largely preserved the Affordable Care Act was a 5-4 decision, with four justices voting to repeal Obamacare in its entirety. If those four justices gain a fifth vote, it could not only strip millions of Americans of the health insurance that they will soon gain under this law, but it could toss the entire American health care system into chaos. Among other things, if the dissent’s plan to repeal the Affordable Care Act in its entirety were to actually happen, Medicare could lose its ability to pay claims until the agency that administers the program completed a lengthy rulemaking process that can take months.

And on top of all this, we could wind up with a president who believes in creationism, or who would choose a Supreme Court justice who would support the teaching of creationism in the schools.